Additional Activity Permission Form

Parent/Guardian First Name *

Parent/Guardian Last Name *

Email Address *

Mobile Phone Number *

Child Information

First Name *

Last Name *

Grade *

Day *

Activity *

Location on School grounds *

Session Start Time *

Session End Time *

Name of organisation and/or name of adult in charge *

Contact Number

Will they return to OSHC at the end of the session? *

YesNo

Please select 'yes' if this will change week to week and ensure you notify the OSHC office in writing if you are picking up directly from the activity

Terms and Conditions

I will regularly remind my child that they must be signed in to OSHC before they attend their activity.

I understand that my child will be signed out of OSHC and transitioned to their activity. Unless stated on this form that they will not be returning to OSHC, they will be transitioned back to OSHC at the end of their session and signed back in.

I understand that the duty of care transfers to the external provider when my child is signed out and no responsibility for my child will be taken by OSHC whilst the child is attending an activity or until my child is signed back into the Service.

If the child is not returning to OSHC i.e. parent is collecting child directly from the activity, the parent or guardian must select 'NO' that they will not be returning to OSHC or contact the OSHC office in writing prior to the end of their session.

I consent to the above terms and conditions *

Signature *

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